title: Risk factors for cholera transmission in Haiti during inter-peak periods: insights to improve current control strategies from two case-control studies.
abstract: Two community-based density case-control studies were performed to assess risk factors for cholera transmission during inter-peak periods of the ongoing epidemic in two Haitian urban settings, Gonaives and Carrefour. The strongest associations were: close contact with cholera patients (sharing latrines, visiting cholera patients, helping someone with diarrhoea), eating food from street vendors and washing dishes with untreated water. Protective factors were: drinking chlorinated water, receiving prevention messages via television, church or training sessions, and high household socioeconomic level. These findings suggest that, in addition to contaminated water, factors related to direct and indirect inter-human contact play an important role in cholera transmission during inter-peak periods. In order to reduce cholera transmission in Haiti intensive preventive measures such as hygiene promotion and awareness campaigns should be implemented during inter-peak lulls, when prevention activities are typically scaled back.
authors.affiliation: Epicentre, Paris,France.
authors.forename: F
authors.initials: F
authors.lastname: Grandesso
authors.affiliation: Epicentre, Paris,France.
authors.forename: M
authors.initials: M
authors.lastname: Allan
authors.affiliation: Médecins sans Frontières, Paris,France.
authors.forename: P S J
authors.initials: PS
authors.lastname: Jean-Simon
authors.affiliation: Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince,Haiti.
authors.forename: J
authors.initials: J
authors.lastname: Boncy
authors.affiliation: Epicentre, Paris,France.
authors.forename: A
authors.initials: A
authors.lastname: Blake
authors.affiliation: Direction Sanitaire de l'Artibonite, Gonaives,Haiti.
authors.forename: R
authors.initials: R
authors.lastname: Pierre
authors.affiliation: Epicentre, Paris,France.
authors.forename: K P
authors.initials: KP
authors.lastname: Alberti
authors.affiliation: Médecins sans Frontières, Paris,France.
authors.forename: A
authors.initials: A
authors.lastname: Munger
authors.affiliation: Médecins sans Frontières, New York,USA.
authors.forename: G
authors.initials: G
authors.lastname: Elder
authors.affiliation: Médecins sans Frontières, New York,USA.
authors.forename: D
authors.initials: D
authors.lastname: Olson
authors.affiliation: Epicentre, Paris,France.
authors.forename: K
authors.initials: K
authors.lastname: Porten
authors.affiliation: Epicentre, Paris,France.
authors.forename: F J
authors.initials: FJ
authors.lastname: Luquero
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000635:transmission*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult